Gender Differences in Lung Neuroendocrine Tumors: A Single-Center Experience

Abstract

<b><i>Introduction:</i></b> Gender difference may affect lung neuroendocrine tumor (L-NET) onset, progression, and outcomes as emerged in other cancers. This study aimed to analyze gender difference in L-NET to identify potential prognostic factors, to improve patient follow-up and therapeutic strategies. <b><i>Methods:</i></b> Patients with histologically confirmed L-NEN diagnosis referred to the ENETS CoE of the Endocrinology Unit, Federico II University of Naples, from 2013 to 2023, were retrospectively evaluated. <b><i>Results:</i></b> Among 48 patients with L-NEN, 38 (79.2%) with sporadic L-NET were enrolled: 22 typical (57.9%) and 16 atypical (42.1%) carcinoids, 22 (57.9%) female and 16 (42.1%) male, mean age at diagnosis 57.3 years (range 16–84). Median follow-up was 70.5 months (range 12–305). No statistical difference resulted regarding smoking habit, BMI, primary site (left/right and central/peripheral), and histological characteristics, between cohorts. Metastasis at diagnosis was found in 20 patients (52.3%), 10 female (10%) and 10 male (10%) (<i>p:</i> 0.20). Progressive disease (PD) was observed in 14 (36.8%) patients, and male sex developed PD more frequently 9/14 (64.3%) than female 5 (35.7%), <i>p:</i> 0.05. Male sex seemed to show more frequently bone metastasis without reaching statistical difference, 7 male/10 (70%), <i>p:</i> 0.06. Among 9 deaths (23.7%), 7 (77.8%) were men and 7 died for PD, <i>p</i> &lt; 0.03. Male had a poorer prognosis than female regarding progression-free survival (PFS) (<i>p:</i> 0.04) and overall survival (<i>p:</i> 0.001), also when sub-groups of patient metastatic at diagnosis were compared (<i>p:</i> 0.02 <i>and p</i>: 0.02). <b><i>Conclusions:</i></b> This study showed a worse prognosis in male than female with L-NET, despite similar clinical features, tumor type, stage, and treatment, with regard to PFS, OS, and metastatic spread. These findings may suggest a closer follow-up in men, with potential positive impact on outcomes.